1. Field of the Invention
The present invention relates to methods of anatomical tissue ligation and, more particularly, to methods of ligating tubular and non-tubular anatomical tissue with a single instrument assembly.
2. Discussion of the Prior Art
Various operative procedures previously performed as open surgery requiring relatively large longitudinal incisions have come to be performed endoscopically. In endoscopic procedures, instruments are introduced at internal operative sites through relatively small, artificially created or natural openings providing communication with the internal operative sites from externally thereof. The instruments are manipulated remotely, from externally of the internal operative sites, to perform various operative procedures under visualization provided by an endoscope. Endoscopic procedures have many advantages over open surgical procedures including minimal invasiveness and trauma, shorter hospital stays and recovery times, minimal scarring and patient discomfort, fewer post-operative complications, lower cost and reduced risk for the patient.
Ligating anatomical tissue is a time consuming and tedious part of both endoscopic and open operative procedures due to the difficulty involved in applying an occluding ligature to anatomical tissue as is necessary and desirable in many various procedures. In particular, multiple, separate instruments are typically required to grasp the anatomical tissue and to position and contract a ligature loop therearound to form a ligature. Furthermore, additional instruments are usually required to cut the ligated anatomical tissue as well as the material of the ligature loop. Ligating anatomical tissue is particularly difficult in endoscopic procedures due to the restricted access to the internal operative sites and the limited room for maneuverability. Accordingly, the advantages of endoscopic procedures are sometimes outweighed by the disadvantages caused by the length of time required to perform endoscopic procedures where such time is significantly extended due to the time required for anatomical tissue ligation.
The use of endoscopic techniques for various operative procedures involving anatomical tissue ligation has been restricted, therefore, by a lack of instrumentation and by procedural difficulties due to the limited room for access, maneuverability and visualization at the internal operative sites and due to the need for various different instruments to be introduced at the internal operative sites. Accordingly, many operative procedures cannot be safely and efficiently performed as endoscopic or laparoscopic surgery and must be performed as open surgery with its attendant disadvantages.